xgad-65-glutamatdecarboxylase-gad-65-antistof-igg (LH Indholdsside)

<Provider Id="sundheddkcms">
  <Item Id="{C123A250-DCFA-45F5-8A7F-D46592836A3A}" Name="xgad-65-glutamatdecarboxylase-gad-65-antistof-igg" Type="LHContentPage" ParentProviderId="sundheddkcms" ParentItemId="{954990FB-BCA1-4322-A1A9-62D3FD4B2E07}" SortOrder="12700" PublishDate="2011-03-16T14:36:00" DeleteDate="2999-12-31T00:00:00" PotItemType="">
    <Content>
      <HtmlField Name="PageContent"><![CDATA[<h2>Resum&eacute;</h2>
<ul>
    <li>Glutamatdecarboxylase-antistof findes hos 90 % af patienter med diabetes mellitus type 1 p&aring; diagnosetidspunktet, og kan bruges til at skelne mellem type 1 og type 2 diabetes<a href="/%20" title="Nilsson-Ehle P (red). Laurells Klinisk kemi i praktisk medicin. 9. udg.. Lund: Studentlitteratur; 2012" data-url="reference-link" data-value-piped="Nilsson-Ehle P (red)|Laurells Klinisk kemi i praktisk medicin. 9. udg.|Lund|Studentlitteratur|2012" data-value="Nilsson-Ehle P (red). Laurells Klinisk kemi i praktisk medicin. 9. udg.. Lund: Studentlitteratur; 2012" data-type="book-reference">1</a>&nbsp;</li>
    <li>GAD-65 antistoffer ses ogs&aring; hos patienter med&nbsp;<a href="~/link.aspx?_id=47DD8F1F4FF145FFA337C6D93B9E73AF&amp;_z=z">stiff person syndrome</a>&nbsp;og patienter med limbisk autoimmun encefalitis<a href="/%20" title="Gagnon MM, Savard M, Limbic Encephalitis Associated With GAD65 Antibodies: Brief Review of the Relevant literature. . Can J Neurol Sci 2016;43: 486-93" data-url="reference-link" data-value-piped="Gagnon MM, Savard M|Limbic Encephalitis Associated With GAD65 Antibodies: Brief Review of the Relevant literature. |Can J Neurol Sci|2016|43|486-93" data-value="Gagnon MM, Savard M, Limbic Encephalitis Associated With GAD65 Antibodies: Brief Review of the Relevant literature. . Can J Neurol Sci 2016;43: 486-93" data-type="journal-reference">2</a></li>
</ul>
<h2>Definition</h2>
<ul>
    <li>Koncentrationsbestemmelse af glutamatdecarboxylase-antistof (glutamic acid decarboxylase) (GAD-65) i serum, m&aring;lt i int.enh./L</li>
</ul>
<h2>Synonymer</h2>
<ul>
    <li>Anti-GAD-65; IgG antistoffer mod glutaminsyre decarboxylase 65 kD isoform</li>
</ul>
<h2>Indikationer</h2>
<ul>
    <li>Differentiering mellem diabetes mellitus&nbsp;<a href="~/link.aspx?_id=6CBEC01CEEED40AFA06F20EC907798E6&amp;_z=z">type 1</a>&nbsp;og&nbsp;<a href="~/link.aspx?_id=DCFE14276A164929B46269AF2CAE5FA2&amp;_z=z">type 2</a>&nbsp;og dermed den overordnede diagnostiske klassificering</li>
    <li>Mistanke om udvikling af diabetes mellitus type 1 hos en patient med diabetes mellitus type 2</li>
    <li>Bekr&aelig;fte/underst&oslash;tte diagnosen af stiff person syndrom, autoimmun encephalitis, cerebellitis, hjernestamme encephalitis og myelitis</li>
    <li>Verificere &oslash;get risiko for organspecifikke neurologiske sygdomme (fx&nbsp;<a href="~/link.aspx?_id=82C1DE5CA6AC45E2A78131B7B2F0CB71&amp;_z=z">myasthenia gravis</a>, Lambert-Eaton syndrom)</li>
</ul>
<h2>Fortolkninger<a href=" " data-type="book-reference" data-value="J Lyngby. Laboratoriemedicin. København: Nyt Nordisk Forlag Arnold Busck; 2010" data-value-piped="J Lyngby|Laboratoriemedicin|København|Nyt Nordisk Forlag Arnold Busck|2010" data-url="reference-link" title="J Lyngby. Laboratoriemedicin. København: Nyt Nordisk Forlag Arnold Busck; 2010">3</a><sup>,</sup><a href=" " data-type="journal-reference" data-value="Nie DA, Abud A, Serrano-Gonzalez M, Harappanahally G, Patil R, Pediatric stiff limb syndrome with polyautoimmunity of anti-GAD-65, anti-islet cell, and thyroid peroxidase antibodies: A case report and review of literature. J Neuroimmunol 2022;367: 577865" data-value-piped="Nie DA, Abud A, Serrano-Gonzalez M, Harappanahally G, Patil R|Pediatric stiff limb syndrome with polyautoimmunity of anti-GAD-65, anti-islet cell, and thyroid peroxidase antibodies: A case report and review of literature.|J Neuroimmunol|2022|367|577865|35468418" data-url="reference-link" data-pubmedid="35468418" title="Nie DA, Abud A, Serrano-Gonzalez M, Harappanahally G, Patil R, Pediatric stiff limb syndrome with polyautoimmunity of anti-GAD-65, anti-islet cell, and thyroid peroxidase antibodies: A case report and review of literature. J Neuroimmunol 2022;367: 577865">4</a></h2>
<h3>Positiv for GAD-65-antistof</h3>
<ul>
    <li>Positiv GAD-65-antistof sammen med lavt (meget lavt) P-C-peptid klassificerer patienten som diabetes mellitus type 1
    <ul>
        <li>Kan udvikle absolut insulinmangel</li>
    </ul>
    </li>
    <li>Sensitivitet (~80%), specificitet (~99%) og positiv pr&aelig;diktiv v&aelig;rdi (~60 %). Tilstedev&aelig;relse af GAD65-Ab i kombination med andre autoantistoffer mod &szlig;-celle-antigener, &oslash;ger den positive pr&aelig;diktive v&aelig;rdi til &gt;95 %. </li>
    <li>Gad65-Ab kan persistere i mange &aring;r, i mods&aelig;tning til de &oslash;vrige &oslash;-celle-autoantistoffer, og er relativt uafh&aelig;ngig af debutalder</li>
    <li>Kan ofte p&aring;vises f&oslash;r kliniske tegn p&aring; diabetes mellitus type 1</li>
    <li>Sandsynligheden for at diagnosticere diabetes mellitus type 1 &oslash;ges betydeligt ved samtidig analyse for &oslash;-celle-antistoffer
    <ul>
        <li>90 % sandsynlighed for positivt resultat ved en af de to test hos patienter med diabetes mellitus type 1</li>
    </ul>
    </li>
    <li>Efter langt sygdomsforl&oslash;b kan antistofferne falde og blive negative</li>
    <li>Gad-65-antistof ses ved mange andre autoimmune sygdomme, dog ofte til stede i lav koncentration</li>
    <li>Behandling af GAD-65 positiv encefalitis og andre GAD-65 positive neurologiske sygdomme b&oslash;r ske p&aring; neurologisk specialafdeling</li>
</ul>
<h2>Fejlkilder (og kilder til normal variation)</h2>
<ul>
    <li>H&aelig;molyse</li>
</ul>
<h2>Biokemisk baggrund<a href="%20" title="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H. Medicinsk Kompendium. København: Nyt Nordisk Forlag Arnold Busck A/S; 2009" data-url="reference-link" data-value-piped="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H|Medicinsk Kompendium|København|Nyt Nordisk Forlag Arnold Busck A/S|2009" data-value="Schaffalitzky de Muckadell O, Haunsø S, Vilstrup H. Medicinsk Kompendium. København: Nyt Nordisk Forlag Arnold Busck A/S; 2009" data-type="book-reference">5</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BC123A250-DCFA-45F5-8A7F-D46592836A3A%7D&amp;ed=FIELD3041068654&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H3041068718&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: " data-value-piped="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A|Neurological Syndromes Associated with Anti-GAD Antibodies.|Int J Mol Sci|2020|21||32456344" data-url="reference-link" data-pubmedid="32456344" title="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: ">6</a><sup>,</sup><a href="EditorPage.aspx?da=core&amp;id=%7BC123A250-DCFA-45F5-8A7F-D46592836A3A%7D&amp;ed=FIELD3041071368&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H3041071432&amp;mo&amp;pe=0&amp;fbd=1" data-type="book-reference" data-value="J Lyngby. Laboratoriemedicin. København: Nyt Nordisk Forlag Arnold Busck; 2010" data-value-piped="J Lyngby|Laboratoriemedicin|København|Nyt Nordisk Forlag Arnold Busck|2010" data-url="reference-link" title="J Lyngby. Laboratoriemedicin. København: Nyt Nordisk Forlag Arnold Busck; 2010">3</a></h2>
<ul>
    <li>GAD-65-antistof er cirkulerende autoantistoffer mod &beta;-celleantigener (glutaminsyredecarboxylase) i cellerne i de Langerhanske &oslash;er i pancreas
    <ul>
        <li>Findes hos patienter med autoimmun diabetes mellitus, diabetes mellitus <a href="~/link.aspx?_id=6CBEC01CEEED40AFA06F20EC907798E6&amp;_z=z">type 1</a></li>
        <li>Medf&oslash;rer autoimmun inflammation i &oslash;-cellerne i pancreas og dermed &oslash;del&aelig;ggelse af de insulinproducerende &beta;-celler</li>
    </ul>
    </li>
    <li>Glutamatdecarboxylase katalyserer omdannelsen af glutamate til GABA og CO2 </li>
    <li>GAD eksisterer i to isoformer kodende fra to forskellige gener
    <ul>
        <li>GAD 67 med molekylv&aelig;gt 67 kD, udtrykkes i hjernen (centralt og i dendritter)&nbsp; og sikrer et basalt niveau af GABA</li>
        <li>GAD 65 med molekylv&aelig;gt 65 kD, udtrykkes i hjernen (pr&aelig;synapser), hvor det er inaktivt. Ved skift til aktivt stade sker den en hurtig syntese af GABA<a href="EditorPage.aspx?da=core&amp;id=%7BC123A250-DCFA-45F5-8A7F-D46592836A3A%7D&amp;ed=FIELD3041068654&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H3041068718&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: " data-value-piped="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A|Neurological Syndromes Associated with Anti-GAD Antibodies.|Int J Mol Sci|2020|21||32456344" data-url="reference-link" data-pubmedid="32456344" title="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: ">6</a>.&nbsp;Findes ogs&aring; i pancreasv&aelig;v, &beta;-cellerne i Langerhanske &oslash;er </li>
    </ul>
    </li>
    <li>Da GAD-65 koncentrationen kan falde ved lang tids sygdom, har analysen st&oslash;rst betydning p&aring; diagnosetidspunktet </li>
    <li>Patienter som formodes at have diabetes mellitus type 2, men som er GAD-65- antistof positive, klassificeres som diabetes mellitus type 1 med langsom sygdomsudvikling
    <ul>
        <li>LADA (Latent Autoimmune Diabetes in Adults)</li>
    </ul>
    </li>
    <li>I neurologien er GAD antistof associeret med<a href="EditorPage.aspx?da=core&amp;id=%7BC123A250-DCFA-45F5-8A7F-D46592836A3A%7D&amp;ed=FIELD3041068654&amp;vs&amp;la=da&amp;fld=%7B850D32D3-55A1-49E4-9CDF-F0C88D91563C%7D&amp;so=%2Fsitecore%2Fsystem%2FSettings%2FHtml%20Editor%20Profiles%2FRich%20Text%20LHPH&amp;di=0&amp;hdl=H3041068718&amp;mo&amp;pe=0&amp;fbd=1" data-type="journal-reference" data-value="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: " data-value-piped="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A|Neurological Syndromes Associated with Anti-GAD Antibodies.|Int J Mol Sci|2020|21||32456344" data-url="reference-link" data-pubmedid="32456344" title="Dade M, Berzero G, Izquierdo C, Giry M, Benazra M, Delattre JY, Psimaras D, Alentorn A, Neurological Syndromes Associated with Anti-GAD Antibodies. Int J Mol Sci 2020;21: ">6</a>
    <ul>
        <li>Encephalomyelitis eller limbisk encefalitis med eller uden samtidig forekomst af cancer&nbsp;</li>
        <li>Paraneoplastic cerebellar ataksi (PCD)&nbsp;</li>
        <li>Temporallaps epilepsi<a href=" " data-type="journal-reference" data-value="Daif A, Lukas RV, Issa NP, Javed A, VanHaerents S, Reder AT, Tao JX, Warnke P, Rose S, Towle VL, Wu S, Antiglutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy. Epilepsy Behav 2018;80: 331-336" data-value-piped="Daif A, Lukas RV, Issa NP, Javed A, VanHaerents S, Reder AT, Tao JX, Warnke P, Rose S, Towle VL, Wu S|Antiglutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy.|Epilepsy Behav|2018|80|331-336|29433947" data-url="reference-link" data-pubmedid="29433947" title="Daif A, Lukas RV, Issa NP, Javed A, VanHaerents S, Reder AT, Tao JX, Warnke P, Rose S, Towle VL, Wu S, Antiglutamic acid decarboxylase 65 (GAD65) antibody-associated epilepsy. Epilepsy Behav 2018;80: 331-336">7</a></li>
        <li><a href="~/link.aspx?_id=C123A250DCFA45F58A7FD46592836A3A&amp;_z=z">Stiff-person syndrom (SPS)</a>&nbsp;og varianter heraf inklusive progressiv encephalomyelitis med rigiditet og myoclonus (PERM)</li>
    </ul>
    </li>
</ul>
<h2>Pr&oslash;vetagning</h2>
<ul>
    <li>Veneblodpr&oslash;ve
    <ul>
        <li>Serum - r&oslash;r uden antikoagulans - r&oslash;d prop med eller uden gel</li>
    </ul>
    </li>
    <li>P&aring; samme r&oslash;r kan udf&oslash;res &oslash;-celle-antistof</li>
</ul>
<h2>Analysetest</h2>
<ul>
    <li>Indirekte immunflourescens/ELISA</li>
</ul>
<h2>Referenceintervaller</h2>
<h3>P- glutamatdecarboxylase(GAD-65)-antistof (IgG)</h3>
<ul>
    <li>Negativ: &lt; 5 U/L</li>
    <li>Positiv: &ge; 5 U/L</li>
</ul>
<h2>NPU-koder og -navne</h2>
<ul>
    <li>NPU26737</li>
    <li>NPU29550</li>
    <li>NPU12544</li>
    <li>NPU12546</li>
    <li>NPU28627</li>
    <li>NPU28628</li>
    <li>NPU54726</li>
    <li>NPU54727</li>
    <li>NPU28103</li>
</ul>
<h3>Navne</h3>
<ul>
    <li><strong>Langt navn</strong>
    <ul>
        <li>P-Glutamatdecarboxylase(gad65)-Ab</li>
        <li>Csv&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.k.(proc.) = ?</li>
        <li>P&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.k.(proc.) = ?</li>
        <li>P&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(ELISA; proc.) = ? (p.d.e.)&nbsp;</li>
        <li>Csv&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(IRP 97/550; ELISA; proc.) = ? &times; 10&sup3; IU/L</li>
        <li>P&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(IRP 97/550; ELISA; proc.) = ? &times; 10&sup3; IU/L&nbsp;</li>
        <li>Csv&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(proc.) = ? (p.d.e.)&nbsp;</li>
        <li>P&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(proc.) = ? (p.d.e.)</li>
        <li>Csv&mdash;Glutamate decarboxylase 2-antistof(IgG); arb.stofk.(RIA; proc.) = ? (p.d.e.)</li>
    </ul>
    </li>
    <li><strong>Kort navn</strong>
    <ul>
        <li>Glutam.decarb.(gad65)-IgG;Csv</li>
        <li>Glutam.decarb.(gad65)-IgG;P</li>
    </ul>
    </li>
</ul>
<h2>Opf&oslash;lgning p&aring; unormale resultater</h2>
<ul>
    <li>Behandling som diabetes mellitus type 1
    <ul>
        <li><a href="http://pro.medicin.dk/Laegemiddelgrupper/Grupper/33000">Insulinbehandling</a></li>
    </ul>
    </li>
    <li>Ved uventet negativ resultat unders&oslash;ges for &oslash;-celle antistoffer</li>
</ul>]]></HtmlField>
      <LinkListField Name="Spot2">
        <LinkField linktype="internal">{99A85AFD-2F7A-4B5D-A1C9-C2701D5E7D30}</LinkField>
      </LinkListField>
      <TextField Name="DoctorsHandbookID">2945</TextField>
      <TextField Name="PageTitle">(GAD-65) Glutamatdecarboxylase (gad 65)-antistof (IgG)</TextField>
      <TextField Name="NavigationTitle">(GAD-65) Glutamatdecarboxylase (gad 65)-antistof (IgG)</TextField>
      <CheckBoxField Name="ShowInMenu">true</CheckBoxField>
      <CheckBoxField Name="ShowInContentField">true</CheckBoxField>
      <DateTimeField Name="RevisedDate">2023-02-17T14:34:00</DateTimeField>
      <LinkListField Name="Authors">
        <LinkField linktype="internal">{E3258509-7DFB-4092-BE9F-B584BD8A18BA}</LinkField>
        <LinkField linktype="internal">{ED7CEC94-3F7A-4FB5-BBB0-A3681BCFC481}</LinkField>
      </LinkListField>
      <LinkListField Name="Organization">
        <LinkField linktype="internal">{CF77E8B9-9937-42B2-85DF-76B0F4E401F0}</LinkField>
      </LinkListField>
      <LinkListField Name="SearchAreaID">
        <LinkField linktype="internal">3</LinkField>
      </LinkListField>
      <TextField Name="Description">Glutamatdecarboxylase-antistof findes hos 90 % af patienter med diabetes mellitus Type 1 på diagnosetidspunktet, og kan bruges til at skelne mellem Type 1 og Type 2 diabetes.</TextField>
      <LinkListField Name="LHPHEditor">
        <LinkField linktype="internal">{37FAF8C0-7527-48CA-9ECE-FCC7E8CBB368}</LinkField>
      </LinkListField>
      <TextField Name="__Updated by">sitecore\anda</TextField>
      <TextField Name="MetaKeywords">antifosfolipid antistoffer., anti-gad, lada, latent autoimmune diabetes in adults, Glutamatdecarboxylase , (gad-65)glutamatdecarboxylase (gad 65)-antistof (igg), (GAD-65) Glutamatdecarboxylase (gad 65)-antistof (IgG)</TextField>
      <LinkListField Name="InformationCategory">
        <LinkField linktype="internal">IC_3</LinkField>
      </LinkListField>
      <LinkListField Name="InformationType">
        <LinkField linktype="internal">7</LinkField>
      </LinkListField>
      <LinkListField Name="SearchTargetGroup">
        <LinkField linktype="internal">2</LinkField>
      </LinkListField>
    </Content>
    <Medias />
  </Item>
</Provider>

17.331 characters